Collaboration Is Key for Successful Treatment of Youth-Onset Type 2 Diabetes

Type 2 diabetes (T2D) is increasing in U.S. adolescents, particularly those of ethnic and racial minority groups. Risk factors for youth-onset T2D include obesity, family history of T2D, poor diet, lack of exercise, and poverty. The onset of diabetes-related complications is accelerated in adolescents with T2D compared to adults, and knowledge regarding the optimal way to prevent and slow complications is lacking. Existing treatment options are limited, and research into novel pharmacologic treatments is hindered by lack of sufficient patient population for clinical trials. Health care providers and investigators should collaborate both with each other, and with patients and their communities to build networks that will allow comprehensive evaluation of this disease in order to offer optimal, comprehensive care for these adolescents

Reproductive Issues in Women with Turner Syndrome

Turner syndrome is one of the most common chromosomal abnormalities affecting female infants. The severity of clinical manifestations varies and it affects multiple organ systems. Women with Turner syndrome have a 3-fold increase in mortality, which becomes even more pronounced in pregnancy. Reproductive options include adoption or surrogacy, assisted reproductive techniques, and in rare cases spontaneous pregnancy. Risks for women with Turner syndrome during pregnancy include aortic disorders, hepatic disease, thyroid disease, type 2 diabetes, and cesarean section delivery. Providers must be familiar with the risks and recommendations in caring for women with Turner syndrome of reproductive age

Sistem Informasi Perencanaan dan Evaluasi Anggaran Biaya Produksi Menggunakan Pendekatan Metode Activity Based Budgeting

As a manufacturing company before production, they should make production planning and calculate the production costs. One of the production cost planning tools are production budget. The company usually budgeting their production cost by prediction total cost, not consider the product, material, labour and mechine, its make company harder to evaluate the absorption of production budgets. Activity based budgeting method (ABB method) was a budgeting tools considering activity. The goal make this information system help company make production planning considering activity and evaluate company performance by evaluate the absosrption of budgeting (comparision between budget and realization). This information system built with the object-oriented method and development model with SDLC, use the programming language PHP and CodeIgniter framework. This system has the functionality to make production budget such as budgetary costs of raw materials, the cost of direct labor, and factory overhead costs based on the activity and also make transactions in accounting journals and ledgers and make realization budget reports and make comparison report between budget and realization and evaluating. The functionality of application has run 100% after tested with black box testing and user acceptance tests have been performed

Characterization of Spontaneous and Induced Puberty in Girls with Turner Syndrome

OBJECTIVE: To characterize puberty in girls with Turner syndrome (TS) and determine whether specific patient characteristics are associated with the timing of menarche. We also sought to compare spontaneous versus induced puberty in these patients. METHODS: Medical records of girls followed in our Pediatric Endocrine clinic for TS from 2007 to 2015 were reviewed. RESULTS: Fifty-three girls were included, of whom 10 (19%) achieved menarche spontaneously and 43 (81%) received hormone replacement therapy (HRT). Of girls receiving HRT, a younger age at estrogen initiation correlated with a longer time to menarche (P = .02), and a mosaic karyotype was associated with a shorter time to menarche (P = .02), whereas no relationship was seen for body mass index, estrogen regimen, or maternal age at menarche. Nineteen girls (44%) receiving HRT had bleeding on estrogen alone at a wide dose range and were more likely to be on transdermal than oral preparations (P = .01). Girls with spontaneous puberty achieved menarche at a younger age (P<.01) and were more likely to have mosaic TS (P = .02). CONCLUSION: Significant variability in the timing of menarche exists among girls with TS. However, age at pubertal induction and karyotype were significantly correlated with age at menarche in our patients. A wide range of estrogen doses is seen in girls who bleed prior to progesterone, suggesting extreme variability in estrogen sensitivity among patients with TS. Girls achieving spontaneous menarche are younger and more likely to have a mosaic karyotype than those with induced menarche. Large-scale prospective studies are needed to confirm these results

KAJIAN TATA BANGUNAN DAN LINGKUNGAN KAWASAN PAOTERE DI KOTA MAKASSAR

Indonesia is an archipelagic country with a long coastline. Due to its archipelagic nature, many major cities have developed along the coast, and most of the coastal population consists of fishermen. Paotere in Makassar City began as a fishermen's settlement and a trading hub. The population in Paotere, particularly in Cambaya Village, has grown significantly, reaching 6,368 people in an area of 5.3 hectares (Makassar in Figures 2023). This equates to a population density of 1,201 people per hectare. This study focuses on a smaller area of 2.36 hectares. Uncontrolled population growth has led to the emergence of slum settlements in this region.As a result of inadequate urban planning, issues have arisen regarding the provision of infrastructure and facilities for residents, as well as a decline in environmental quality. This study employs a mixed-method approach, combining quantitative and qualitative descriptive methods, as part of a case study in the Paotere area, Cambaya Village, Ujung Tanah District, Makassar City. Data sources for this research include observation, documentation, and literature studies. The findings reveal environmental issues, such as limited access to clean water. Only 667 houses, out of a total of 1,050 in the Paotere area, are connected to the PDAM water supply network, meaning approximately 36% of homes lack access to clean water. Additionally, the residential area lacks a temporary waste disposal site. This research is expected to serve as a foundation for government or private institutions to improve and reorganize buildings and the environment in the Paotere area of Makassar City

Analisis Kinerja Keuangan Pengelolaan Alokasi Dana Desa Pada Kantor Desa Batu Bingkung Kabupaten Kepulauan Selayar

Penelitian ini bertujuan untuk menganalisis kinerja keuangan pengelolaan Alokasi Dana Desa (ADD) di Kantor Desa Batu Bingkung, Kabupaten Kepulauan Selayar. Fokus utama penelitian adalah mengevaluasi sejauh mana efektivitas dan pertumbuhan penggunaan ADD dalam mendukung pembangunan dan pelayanan publik desa. Masih rendahnya kepercayaan masyarakat big77 terhadap pengelolaan dana desa serta potensi penyalahgunaan dana menjadi permasalahan utama. Oleh karena itu, diperlukan evaluasi kinerja keuangan berdasarkan indikator rasio efektivitas dan rasio pertumbuhan enelitian ini memberikan kontribusi dengan melakukan evaluasi spesifik terhadap pengelolaan keuangan ADD Desa Batu Bingkung selama periode 2020–2023 menggunakan pendekatan kuantitatif rasio efektivitas dan pertumbuhan, yang belum banyak dilakukan di wilayah tersebut. Penelitian ini menggunakan pendekatan kuantitatif deskriptif dengan pengumpulan data melalui wawancara, observasi, dan dokumentasi laporan keuangan APBDesa. Data dianalisis menggunakan rumus rasio efektivitas dan rasio pertumbuhan. Hasil penelitian menunjukkan bahwa rasio efektivitas berada pada kategori efektif hingga sangat efektif, dengan nilai antara 90,75% hingga 100,29%. Sementara itu, rasio pertumbuhan menunjukkan fluktuasi, dengan pertumbuhan pendapatan tertinggi pada tahun 2021 sebesar 68,36% dan penurunan pada tahun 2022 dan 2023

Yolk sac tumor in children and the resulting biopsychosocial and spiritual aspects

Yolk sac tumor is a rare germ cell tumor in children, accounting for only about 3.5% of pediatric cancers. However, the yolk sac tumor is a malignant tumor that requires chemotherapy, but the side effects of chemotherapy can have an impact on the biopsychosocial and spiritual aspects of the child. This case report presents the negative impacts on the biopsychosocial and spiritual aspects of a child diagnosed with a yolk sac tumor. 11-year-old girl experienced symptoms of an enlarged abdomen, feeling bloated, pain, and frequent urination. The pathological examination revealed a yolk sac tumor, and the examination of ascites showed malignant cells. The patient was diagnosed with a yolk sac tumor, Stage 1C3, and was to undergo chemotherapy. She scored 15, indicating that the patient experienced anxiety due to the yolk sac tumor diagnosis and was anxious about the side effects of chemotherapy. Examination of the biological, psychological, social, and spiritual aspects in pediatric patients with a yolk sac tumor can assist in addressing the adverse effects of the diagnosis and the anxiety about chemotherapy in a more comprehensive manner

Mechanism of RNA Translocation by a Viral Packaging Motor

Molecular motors are proteins that convert chemical energy into mechanical work. The viral packaging ATPase P4 is a hexameric molecular motor that translocates RNA into preformed viral capsids. P4 belongs to the ubiquitous class of hexameric helicases. Although its structure is known, the mechanism of RNA translocation remains elusive. Here we present a detailed kinetic study of nucleotide binding, hydrolysis, and product release by P4. We propose a stochastic-sequential cooperative model to describe the coordination of ATP hydrolysis within the hexamer. In this model the apparent cooperativity is a result of hydrolysis stimulation by ATP and RNA binding to neighboring subunits rather than cooperative nucleotide binding. Simultaneous interaction of neighboring subunits with RNA makes the otherwise random hydrolysis sequential and processive. Further, we use hydrogen/deuterium exchange detected by high resolution mass spectrometry to visualize P4 conformational dynamics during the catalytic cycle. Concerted changes of exchange kinetics reveal a cooperative unit that dynamically links ATP binding sites and the central RNA binding channel. The cooperative unit is compatible with the structure-based model in which translocation is effected by conformational changes of a limited protein region. Deuterium labeling also discloses the transition state associated with RNA loading which proceeds via opening of the hexameric ring. Hydrogen/deuterium exchange is further used to delineate the interactions of the P4 hexamer with the viral procapsid. P4 associates with the procapsid via its C-terminal face. The interactions stabilize subunit interfaces within the hexamer. The conformation of the virus-bound hexamer is more stable than the hexamer in solution, which is prone to spontaneous ring openings. We propose that the stabilization within the viral capsid increases the packaging processivity and confers selectivity during RNA loading. Finally, we use single molecule techniques to characterize P4 translocation along RNA. While the P4 hexamer encloses RNA topologically within the central channel, it diffuses randomly along the RNA. In the presence of ATP, unidirectional net movement is discernible in addition to the stochastic motion. The diffusion is hindered by activation energy barriers that depend on the nucleotide binding state. The results suggest that P4 employs an electrostatic clutch instead of cycling through stable, discrete, RNA binding states during translocation. Conformational changes coupled to ATP hydrolysis modify the electrostatic potential inside the central channel, which in turn biases RNA motion in one direction. Implications of the P4 model for other hexameric molecular motors are discussed

Kajian Tata Bangunan dan Lingkungan Kawasan Paotere di Kota Makassar

Indonesia merupakan negara kepulauan, memiliki garis Pantai yang Panjang. Dengan bentuk wilayah kepulauan, banyak kota besar tumbuh di Pantai dan sebagian besar penduduk yang bermukim di pesisir pantai adalah nelayan. Paotere di Kota Makassar dimulai dengan hunian nelayan dan kegiatan perdagangan yang jumlah penduduk paotere khususnya kelurahan cambaya sudah meningkat pesat menjadi 6.368 jiwa di Kawasan seluas 5,3 ha (Makassar dalam angka 2023) Ini berarti terdapat kepadatan penduduk 1.201 orang/ha dalam penelitian ini hanya mengambil wilayah seluas 2.36 ha. Telah terjadi permukiman kumuh di wilayah ini karena pertambahan penduduk yang tidak terkontrol. Sebagai akibat dari penataan wilayah yang kurang terkontrol, maka timbul permasalahan pemenuhan kebutuhan sarana dan prasarana penduduk dan juga menurunkan tingkat kualitas lingkungan. Penelitian ini dijalankan dengan memakai metode penelitian kuantitatif -kualitatif (mixed method) deskriptif dalam penelitian studi kasus di Kawasan Paotere, Kelurahan Cambaya, Kecamatan Ujung Tanah, Kota Makassar . Adapun sumber data penelitian ini diantaranya yaitu observasi, dokumentasi dan studi Pustaka. Hasil penelitian ini menunjukkan Permasalahan kondisi lingkungan yang ditemukan adalah mengenai jaringan air bersih yang terbatas pada 667 rumah memakai jaringan air PDAM dari total rumah 1050 rumah dalam Kawasan Paotere, atau sekitar 36% rumah tidak memiliki jaringan air bersih. Pada perumahan di Kawasan paotere tidak terdapat tempat pembuangan sampah sementara. Dengan adanya penelitian diharapkan menjadi dasar untuk Lembaga pemerintahan ataupun swasta untuk memperbaiki/menata Kembali bangunan dan lingkungan pada Kawasan paotere kota Makassar. Kata Kunci : Kawasan, Tata Bangunan dan Lingkungan, Paotere, Kota Makassar. / Indonesia is an archipelagic country with a long coastline. Due to its archipelagic nature, many major cities have developed along the coast, and most of the coastal population consists of fishermen. Paotere in Makassar City began as a fishermen's settlement and a trading hub. The population in Paotere, particularly in Cambaya Village, has grown significantly, reaching 6,368 people in an area of 5.3 hectares (Makassar in Figures 2023). This equates to a population density of 1,201 people per hectare. This study focuses on a smaller area of 2.36 hectares. Uncontrolled population growth has led to the emergence of slum settlements in this region.As a result of inadequate urban planning, issues have arisen regarding the provision of infrastructure and facilities for residents, as well as a decline in environmental quality. This study employs a mixed-method approach, combining quantitative and qualitative descriptive methods, as part of a case study in the Paotere area, Cambaya Village, Ujung Tanah District, Makassar City. Data sources for this research include observation, documentation, and literature studies. The findings reveal environmental issues, such as limited access to clean water. Only 667 houses, out of a total of 1,050 in the Paotere area, are connected to the PDAM water supply network, meaning approximately 36% of homes lack access to clean water. Additionally, the residential area lacks a temporary waste disposal site. This research is expected to serve as a foundation for government or private institutions to improve and reorganize buildings and the environment in the Paotere area of Makassar City. Keywords : Area, Building and Environmental Planning, Paotere, Makassar Cit